Classifications for Diabetes in Older Adults

Type 2, Type 1, Latent Autoimmune Diabetes

The risk for diabetes increases with age, making diabetes common in older adults. In fact, approximately 25% of adults over the age of 60 years have diabetes.

Diabetes means that your blood glucose (sugar) level is too high. Your body’s cells need glucose for energy. When you eat, your pancreas releases the hormone insulin, which helps the glucose from food get into your cells. People with diabetes do not make enough insulin or do not use insulin well, causing glucose to build up in their blood and not reach their cells. This can lead to complications including damage to the heart, eyes, kidneys, and feet.

While type 1 diabetes is usually thought of as beginning in childhood and type 2 diabetes as a beginning in adulthood, it is becoming more clear that adults—including older adults—can develop new-onset type 1 diabetes and that children can develop type 2 diabetes. The different classifications of diabetes that may occur in older people are described below.

Type 2 Diabetes
People with type 2 diabetes do not make or use insulin well. This is the most common type of diabetes and typically occurs in people who are overweight and inactive. Other risk factors include a family history of the disease, older age, certain ethnicities (blacks, Hispanics, American Indians and Asian-Americans), polycystic ovary syndrome, and a history of gestational diabetes (diabetes in pregnancy).

Type 1 Diabetes
People with type 1 diabetes make little or no insulin and need to take insulin therapy as soon as they are diagnosed. Type 1 diabetes typically begins in childhood, but also may first begin in adulthood. This form is typically caused by an autoimmune disorder, meaning that the body’s immune system mistakenly attacks cells that make insulin. In some people, type 1 diabetes may occur after a viral infection, such as cytomegalovirus, encephalitis, Epstein-Barr virus, influenza, measles, mumps, polio, or rubella. In rare cases, type 1 diabetes may occur after injury to the pancreas from trauma or toxins.

Latent Autoimmune Diabetes in Adults (LADA)
This is a subtype of type 1 diabetes that occurs in adulthood. Similar to type 1 diabetes, LADA is an autoimmune disorder in which the body’s immune system mistakenly attacks cells in that make insulin. In contrast to adults with type 2 diabetes, adults with LADA are often thin and may lack a family history of diabetes. People with LADA typically need to take insulin within 6 months of diagnosis.

All forms of diabetes require careful treatment and management over a lifetime.